Abstract Information 
Abstract ID
20260076
Category
Knee: ACL
Preferable Presentation
Both
Title
BILATERAL ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH SYNTHETIC GRAFT AUGMENTATION IN A PROFESSIONAL FOOTBALL PLAYER: A CASE REPORT
Author
  • Full Name: DHARAN KUMAR N.S
  • Affiliation/Institution: Sri Ramachandra centre for sports sciences
  • Country: India

  • Full Name: SANJAY A.K
  • Affiliation/Institution: Sri Ramachandra centre for sports sciences
  • Country: India

  • Full Name: VIGNESH MURALI
  • Affiliation/Institution: Sri Ramachandra centre for sports sciences
  • Country: India

  • Full Name: SAI ADITYA RAMAN
  • Affiliation/Institution: Sri Ramachandra centre for sports science
  • Country: India

  • Full Name: SURESH PERUMAL
  • Affiliation/Institution: Sri ramachandra centre for sports sciences
  • Country: India

  • Full Name: KA THIAGARAJAN
  • Affiliation/Institution: Sri ramachandra centre for sports sciences
  • Country: India

  • Full Name: ARUMUGAM S
  • Affiliation/Institution: Sri ramachandra centre for sports sciencs
  • Country: India
Presenter
Dharan kumar N.s
Abstract
                                                                                                                          

BACKGROUND

Anterior cruciate ligament (ACL) injuries are common in football players and present unique challenges when bilateral involvement occurs. Although autograft reconstruction remains the standard, donor-site morbidity, early strength deficits, and delayed functional progression are particularly limiting in elite athletes. Modern synthetic graft augmentation techniques have re-emerged as a potential alternative by providing immediate mechanical stability, eliminating graft harvest–related morbidity, and supporting early rehabilitation.

OBJECTIVES

To describe the early clinical, radiological, and rehabilitation outcomes of bilateral arthroscopic ACL reconstruction using synthetic graft augmentation in a professional football player, and to assess its feasibility in high-demand athletic populations.

STUDY DESIGN & METHODS

This case report involves a 21-year-old male professional football player with a one-year history of bilateral knee pain and instability sustained during play. Clinical examination demonstrated positive Lachman and anterior drawer tests bilaterally, with preserved pre-operative knee range of motion (0–120°). Magnetic resonance imaging of both knees confirmed complete ACL tears with no associated meniscal or significant chondral pathology. Given the bilateral injury, elite performance demands, and the desire to avoid donor-site morbidity, staged bilateral arthroscopic ACL reconstruction with synthetic graft augmentation was performed. Surgery involved anatomic tunnel placement with secure femoral and tibial fixation of the synthetic ligament to restore native ACL biomechanics and provide immediate post-operative stability. Post-operatively, the athlete followed a structured, accelerated, criterion-based rehabilitation protocol emphasizing early range of motion, neuromuscular control, balance training, and progressive strengthening.

RESULTS

At two months post-operative follow-up, the athlete demonstrated improved knee stability with restoration of near-full, symmetrical range of motion bilaterally. Early strength assessment showed favorable limb symmetry with no extensor mechanism weakness, allowing progression to advanced strengthening phases. Balance and neuromuscular control exercises were well tolerated without pain or effusion. The absence of graft harvest morbidity facilitated uninterrupted lower-limb strengthening and functional training, contrasting with commonly reported early-phase strength inhibition and rehabilitation limitations observed following autograft ACL reconstruction. No early post-operative complications were noted.

CONCLUSION

This early clinical experience suggests that synthetic graft augmentation in bilateral ACL reconstruction may offer practical advantages in selected elite athletes by enabling early restoration of range of motion, strength symmetry, and balance while avoiding donor-site morbidity. These features may support efficient early functional recovery during the initial rehabilitation phase. Continued follow-up is required to evaluate mid-term functional outcomes and return-to-sport parameters.

KEYWORDS

ACL reconstruction, synthetic graft augmentation, bilateral ACL injury, professional footballer, early outcomes, rehabilitation.